Comparison of open and laparoscopic inguinal hernia repair

Abstract

Inguinal hernia repair is one of the most commonly performed general surgery operations. Throughout the years there have been many variations and advancements, including open and laparoscopic techniques, to accomplish the same task of reducing herniated contents and preventing groin hernia recurrence. An array of factors contributes to deciding which operative technique is the best approach to managing a patient presenting with an inguinal hernia. Published data vary due to the heterogeneity of techniques compared, patient presentations, and surgeon expertise. In experienced hands, laparoscopic repair results in a quicker return to work and reduced postoperative pain. Patients with bilateral groin hernias, female patients with groin hernias, and patients with recurrent hernias after prior anterior mesh repair should be offered a laparoscopic preperitoneal mesh approach, when surgeons have the appropriate skill set and experience. We find that open and laparoscopic techniques of inguinal hernias can both achieve exceptional outcomes when applied to the right patient population. To know one’s own capabilities, it is beneficial for surgeons to have baseline familiarity of the multitude of methods of repair, become proficient in both mesh and mesh-free techniques as well as open and laparoscopic techniques to best tailor the surgery to the patient and the clinical circumstances, and follow personal outcomes to evaluate individual results.

Keywords

Hernia / inguinal / herniorrhaphy / laparoscopy / Lichtenstein

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